Wufoo
Mornings with Mommy
Parent's Name
*
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Last
Email
*
Address
*
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Address Line 2
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Cell Phone
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Theme/Date Selection - Sessions are filled at 20 children, when a session is filled you will be notified that you have been placed on a waiting list.
*
Jan 10, "Colors and Shapes"
Jan 24, "Winter Days:Snowflakes, Hats and Mittens"
Feb 7, "Red, Hearts and Valentine's Day"
Feb 28, "Moon, Stars and Night-Time"
Mar 7, "Fun with Food"
Mar 28, "Eggs and Easter - Jesus is Risen!"
Apr 4, "Rain, Clouds and Puddles"
Apr 18, "Frogs, Ducks and Pond Animals"
May 2, "Flowers, Birds and Mother's Day"
May 16, "Monkeys, Zebras and the Zoo"
Number of children attending, ages 0-5
0
1
2
3
Name(s) of child(ren) attending, followed by their age
*
Do any of the children have allergies or other medical concerns we need to be aware of?
Do you have a church home?
*
Yes
No
I hereby give my consent as the parent/guardian of the above named child/children to attend/participate in the Mornings with Mommy program at Amazing Love Lutheran Church at 21301 Pfeiffer Road, Frankfort, IL 60423. My child and I hereby release, indemnify, and hold harmless the church, its employees and/or volunteers from any and all liability from any claim, injury, or loss sustained by or during my child’s participation during Mornings with Mommy. I hereby authorize Amazing Love to take and use photography and/or video of my child for crafts, keepsakes, or promotional purposes in any type of media and understand I will not be compensated for any such use. Please type your full name in the box below agreeing with this consent form.
*
Do Not Fill This Out